Healthy Caribbean 2008 Caribbean Chronic Disease Conference Barbados 18 th October 2008

1. Report on Workshop – “Mobilizing the Caribbean Private Sectors response to CNCD’s & the role of the Private Sector in tackling the Chronic Diseases Healthy Caribbean 2008 Caribbean Chronic Disease Conference Barbados 18th October 2008

2. Agenda • CAIC & PAHO Workshop Report – “Mobilising the Caribbean Private Sector Response to Chronic Diseases” • Causes of Illness • Wellness & Enhanced Lifestyle Programme • Workplace Wellness • Developing a Wellness Programme • Conclusions

3. Mobilising the Caribbean Private Sector Response to Chronic Diseases CAIC & PAHO held the Workshop in Trinidad May 2008 Speakers included: Derrick Cummings –USAID/GHARP Private Sector Partnership Programme & Guyana Business Coalition HIV/AIDS – “perspective on HIV/AID’s Collaboration & Lessons Learned” Dr. Samuels from CAIC – “Status and Response to CNCD Epidemic” Guillermo Penalosa – “Walk & Bike for Life” –“Cities are undergoing a radical change with one thing in mind your well-being”

4. Speakers contd. Sandra Plummer – Deputy Programme Manager Health Sector Development Caribbean Community Secretariat – “Trade Agreement & Health Addressing Chronic Non-Communicable Diseases Unilever – “Promoting Healthier Food Choices & Enhancing Nutritional Quality” BHTA – Sue Springer – “Investing in Health & Wellness for the Tourism Sector”

5. Objectives To encourage the Caribbean Private Sector to take a more active role in the reduction of Chronic Non-Communicable diseases by implementing measures to reduce the risk of these diseases affecting its own employees as well as the wider community. To give support to a Caribbean Wellness Day - September 13, 2008

6. The Key Objective will be facilitated by: Changed Private Sector Policies & Practices that favour chronic non-communicable diseases Adoption of certain areas from the Summit Declaration Regular circulation of Health Information and use Workplace health promotion programmes Promotion of Physical Activities and Healthy Living Increased partnership of Private sector and Government

7. Expected Outcomes The identification of the roles and responsibilities of the Caribbean Private Sector in the reduction of chronic non-communicable diseases An action plan that identifies workplace wellness programmes and activities Statement from the Caribbean Private Sector in support of the initiative

8. Achievements Brainstorming of ideas for Caribbean Wellness Day September 13th 2008 Identification of the need for Wellness Programmes to be placed in ALL companies An Action Plan for the implementation of such programmes The need for communication of current data Continuous Educational programmes

9. Action for Prevention A commitment at the highest level politically to raise awareness for prevention control Establishment & strengthening of national policies & plans for the prevention of chronic diseases Promotion of specific measures & interventions to reduce the risk factors of, & conditions predisposing to, chronic diseases Promotion of partnerships Establishment of systems for monitoring & tracking chronic diseases Promotion of research for the prevention & control

10. CARICOM Heads of Government Declaration ‘The Health of the Region is the Wealth of the Region’ a Declaration made by the CARICOM Heads of Government at their meeting in Nassau in 2001. Here they openly acknowledged for the first time that the health of the people is an essential factor for the region’s development.

11. Caribbean Wellness Non-communicable diseases (NCDs) are major contributors to overall mortality. Cardiovascular disease (hypertension, coronary artery disease and stroke), diabetes and cancer accounted for 51% of deaths in the Caribbean in 2000. The major NCDs in the Caribbean share underlying common risk factors, namely unhealthy eating habits, physical inactivity, obesity, tobacco, alcohol use and inadequate utilisation of preventive health services

12. The Effects & Causes of absenteeism on the 21st Century Workforce Uncertified absenteeism – perceptions of procedural justice Commitment Job Satisfaction Weather Personal Errands Work-family/family-work conflicts Need for improvement in management practices Rapid changes in the workplace generating stress Obesity Lifestyle Diseases

13. Private Sector Support Due to the rising concern of ill health in the Region, the Private Sector is being encouraged to take a more active role in the reduction of non-communicable diseases by implementing measures to reduce the risk of these diseases affecting employees as well as the wider community.

14. Effect on Employers Employees who eat poorly, don’t exercise and fail to schedule routine checkups are likely to: miss more days of work be less productive when at work incur higher medical costs

15. Where is Absenteeism in Barbados? • Recent Absenteeism study carried out by UWI January 2008 • 24 Companies over 3 months • No of employees 4,500 • Total Absenteeism days 10,480 • Absenteeism Rate % = 3.6% (USA rate 2%) • Estimated cost of US$472,605 (based on average wage data) • Annual cost approx US$2M. (Not including real costs – lack of productivity, goodwill ect.)

16. Cost to Employers • Approximate labour force = 145,000 pax • Cost suggests hundreds of millions of dollars per year. • Lowering Absenteeism should be a priority • Reduce absenteeism to 3% • Cost reduction benefit would fund expenditures that directly address the causes of absenteeism • A sustainable approach to absenteeism management

17. Absenteeism by employee demographics • Older employees were less likely to be absent than younger employees • Different values & attitudes towards work • May not have the same family commitments • Personal commitment -Longer periods of services therefore greater level of satisfaction & loyalty • No significant gender difference

18. Costs • Employees did not see certified sick leave as “Costing” their employers due to NIS • Therefore certified sick leave used • Medical Insurance costs – claims experience high

19. Causes of Illness • Chronic diseases most common • Heart & blood disease, cancer, diabetes, HIV/aids & lung diseases • Often occur in middle to later years • May not manifest themselves for many years • Present for many years • High cost of provision for health care • Equals considerable absenteeism, loss of earning capacity & reduced productivity.

20. Chronic Diseases Occur more frequently: • In poverty • Performing dangerous stressful work • Function in polluted work environments • Low political economic power • Discrimination – work & life related conditions that lead to “mental stress & sustained angst” of one kind or another.

21. Chronic Diseases Additional causes: • Inadequate expenditure on health • A bias on health expenditure towards treatment as opposed to prevention of disease • International promotion of soft drinks & alcohol • International & local fast food restaurants

22. BHTA/BWU collaboration for Wellness in Tourism • Tourism is a labour intensive industry • Economy in Barbados reliant on Tourism • Realisation of a need to help workers • Collective agreement for all hotel workers • Meetings with the union • Collaborative approach • Decision to set up wellness committees for all hotels • 2nd phase wellness committees for other tourist entities

23. Developing a Wellness Program • Must be apart of overall company strategy • Health & Safety legislation & work place policies or programs to be in place to provide a basis for a wellness program • Training is essential to any program set up • Inclusion of all parties • Joint labour/management committee set up • Impossible to deal with wellness in isolation from health & safety

24. What are the key elements of a wellness program? • Objectives: Needed to know what we wanted to see happen as a result of the efforts. • Target audience: who was the program for? All staff? Or only certain groups? • Type of program or campaign: What tone will the program have? Informative? Fun? Fearful?

25. How to implement a programme Step 1 Take ownership & leadership & get support from the “top” • Find a leader Step 2 • Get support from Everyone • Union • Management • HR professionals

26. How to implement a programme • Medical or occupational health staff • Health & safety professionals • Local groups e.g., - Public Health - Cancer Society - Heart & Stroke Foundation - Diabetes ect.

27. What is already in place? Step 3 – Acknowledge current activities & collect baseline data • Research if hotels had any existing programs • Collect information re any groups carrying out activities e.g. staff walking groups

28. Research Step 4 • Schedules for hotel workers can be challenging to carry out research so all shifts must be covered • Design a survey to obtain needs, attitudes & preferences re the programme • Full-length (confidential external interviewee) • An open one-to-one interview • A mini-survey • Suggestion boxes

29. Research Step 5 • Surveys can be conducted by: • Hosting a luncheon round table • Sending out an informal email questionnaire • Sending a survey with the pay slip • Conducting a survey available on the hotels intranet site if available

30. Develop a plan • Identify and Prioritise the needs • Set realistic targets & timelines • Have short-term & long-term goals • Plan how & when the program will be initiated • Plan how to maintain interest • Know what resources you need for each step

31. Delivery of program Deliver the programme by organising activities into • Education and Awareness – providing knowledge • Skill building – getting staff actively involved in changing their behaviour • Work environment – changes in the workplace to support the initiative

32. Monitor, Evaluate & Maintain the program • Review the program • What is working or not? • When reviewing outcomes evaluate the program based on the aims & objectives set at the beginning • Maintain the program – use the results of the review to gauge what is working , what to change or enhance

33. Workplace Wellness Work Place Occupation, Health & Safety Voluntary Health Services OrganisationalChange

34. Awareness Raising O.H & S VHS Org. Change Raise awareness about the importance of providing input to management about job issues or concerns e.g., stress Raise awareness using a company newsletter about the wide range of benefits of being physically active & the detriments of being inactive Raise awareness about health risks associated with certain hazardous chemicals Awareness Raising

35. Education & Skill Building O.H & S VHS Org. Change Provide information on the best ways to give constructive feedback to management Assist & Teach employees to set small realistic, physical activity goals Provide demos & training on how to handle hazardous products Education & Skill Building

36. Environmental Support O. H & S VHS Org. Change Provide childcare facilities Provide necessary safety equipment & safe facilities Provide fitness facilities in the workplace Environ-mental Support

37. Policy Development O. H & S VHS Org. Change Policies which allow employees a certain amount of work time each year to pursue professional development Allow employees flex time – start early or stay late – take a longer lunch hour to facilitate exercise time Mandate rigorous assessment of possible hazardous materials before employees are exposed to them Policy Development

38. Policy Development • Clear written policies needed to set a standard for all workers to follow • Health related policies can improve productivity & morale • Enhance employee satisfaction • Reduce lost time & staff turnover • Encourage & support physical activity, good nutrition, flex time • Demonstrates an organisations commitment to employees & the corporate values to health

39. Programme components • Education of all employees • Benefits & how to follow wellness & enhanced lifestyle programmes • Education takes place at the workplace & away from workplace • Notice board educational advertisements, healthy lifestyle newsletters, health/wellness “tips” in pay packets, seminars & workshops • Print media, TV & radio educational ads

40. Programme components • Encouraged the banning of tobacco in all indoor workplaces • Provide assistance to workers that do smoke • Lobbying for “No Smoking” legislation that conforms to the provision of the framework Convention on Tobacco control. • Hotels to offer healthy foods in vending machines, company canteens, & canteens • Advocate healthy foods to be made available at affordable prices nationally.

41. Programme components Training programmes for middle management & supervisors • Managing with care • Effective communication skills • Designing of effective orientations skills • Understanding & motivating the new worker All with an emphasis & bias on wellness & enhanced lifestyles.

42. Programme components • Foster a culture of wholesome wellness & enhanced lifestyle at the workplace – Money management • Wellness & enhanced lifestyle awards for employees • Establish 24 hour care facility for children • Get fit challenge & competitions for staff e.g., Group weight loss programme • Awards of points for physical activities to be redeemed for prizes

43. Programme Components • Establishment of a West Coast and South Coast Sports Club • Negotiate & obtain financial benefits aimed at encouraging enhanced lifestyles • Gym discounts for tourism workers • Discounts on health checks by recognised health societies • Discount coupons • Lunch and learn seminars on health related topics

44. Implementation, organisation & Management • An “Oversight Committee” to be established • Senior leadership of BHTA & the BWU • Tourism Wellness & Enhanced Lifestyle Patrol • Persons trained as “Wellness Champions” • Implementation Committee to be established • Consisting of 4 BHTA reps, 4 BWU reps & 6 wellness champions • Individual company based Wellness patrols set up to implement activities within the company & among staff employees.

45. Funding & Financing • This would be provided by the BWU • The BHTA Tourism Fund • Seek a subvention from Government • Pilot project to be implemented for other sectors once proven to be successful

46. Summary • Health & wellness Lifestyle Programmes are critical & more and more companies are recognising the need • The programme must cover ALL aspects, health, money matters, operations ect. • Support services - other private sector entities • Be confidential • Be sensitive • Be patient • Make it fun!

48. I thank You!